（来源：劳动午报） 春节先护胃，血糖更稳定 很多人以为糖尿病患者过年最怕的是"糖"，但临床上常见的另一种"春节翻车"，其实来自胃肠道——吃 得杂、吃得晚、吃得油，再叠加熬夜久坐，最容易出现胃胀、反酸、腹泻、便秘，甚至把血糖也带着一 起紊乱。糖尿病与消化系统的关系，比想象中更紧密： 胃排空变慢 有些糖尿病患者会出现"饭后胃里堵、胀、嗳气"，食物在胃里停留时间更久，血糖可能出 现"先不高、后突然高"的延迟波动。用胰岛素的人更容易出现"前面低、后面高"的状况。 糖尿病饮食不是什么都不能吃 肠道功能更敏感 高油高糖、冷热混吃容易诱发腹泻或胃肠不适。一旦出现呕吐、腹泻、食欲差，进食 减少但用药照旧，低血糖风险会明显上升。 转自：劳动午报 糖尿病患者过年怕碰"糖"，不过很多人不知道，其实胃肠道健康对糖尿病患者也十分重要，过年先把胃 护好，血糖才能稳得住。北京友谊医院消化中心医师张鹤扬、柳珂和检验科主管技师陈翌阳来为我们讲 讲过年期间糖尿病患者怎么吃更健康。 酒精与高脂不只影响血糖 还会刺激胃黏膜、加重反酸。对部分人来说也可能导致胰腺负担加重，尤其 本就有高甘油三酯或胰腺问题史的人更要谨慎。因此，让胃肠道舒服，血糖更容易稳 ...

Core Viewpoint - The article emphasizes that while whole grains are beneficial for health, improper preparation methods, such as grinding them into a paste, can lead to rapid spikes in blood sugar levels. Group 1: Impact of Processing on Blood Sugar - Different forms of whole grains have varying Glycemic Index (GI) values, with processed forms generally having higher GI values compared to whole forms [2][3] - For example, whole barley has a GI of 25, while barley flour has a GI of 66, indicating that processing increases the potential for blood sugar spikes [2][3] - The processing of whole grains into powders or pastes destroys their nutritional advantages, particularly their ability to stabilize post-meal blood sugar levels [3][5] Group 2: Characteristics of Whole Grains - The "soul" of whole grains lies in their intact structure, which helps slow down digestion and reduce blood sugar fluctuations [5][4] - Whole grains retain their bran, germ, and endosperm, which are rich in dietary fiber, vitamins, and minerals, contributing to their low GI values [5][4] - When grains are processed into finer forms, the exposure of starch to digestive enzymes increases, leading to faster digestion and higher GI values [5][6] Group 3: Recommendations for Consuming Whole Grains - To maximize the benefits of whole grains, it is recommended to consume them in their most intact form, such as whole grain rice or steamed vegetables, rather than in processed forms like porridge [8][11] - Choosing naturally flavored whole grains and avoiding those with added sugars, salts, or fats is advised to maintain their health benefits [9][10] - A diverse combination of whole grains can help balance their GI values and provide a wider range of nutrients [12][11]

Core Viewpoint - The article emphasizes that managing blood sugar levels through diet is complex and cannot be simplified to merely eating vegetarian food. It highlights the importance of understanding glycemic index (GI) and glycemic load (GL) in food choices to effectively control blood sugar levels [1][8]. Group 1: Understanding GI and GL - The glycemic index (GI) measures how quickly food raises blood sugar levels, with high GI foods (GI > 70) causing rapid spikes, while low GI foods (GI ≤ 55) help maintain stable blood sugar [1][3]. - Glycemic load (GL) considers both the quality and quantity of carbohydrates in food, calculated as GL = (GI × grams of available carbohydrates) / 100, providing a more comprehensive view of food's impact on blood sugar [1][3]. Group 2: Misleading Vegetarian Options - Certain starchy vegetables like potatoes and yams, often mistaken for healthy options, can significantly raise blood sugar levels when consumed in excess without reducing other carbohydrate sources [5]. - Vegetarian dishes that are high in added sugars and fats, such as fried or heavily sauced items, can also negatively impact blood sugar levels despite being plant-based [6][10]. Group 3: Health Risks of Unhealthy Vegetarian Diets - A poorly balanced vegetarian diet can lead to health risks, including nutrient deficiencies (e.g., protein, vitamin B12, iron, zinc, calcium) that may adversely affect blood sugar control and overall health [10][11]. - The quality of food is more critical than the "meat vs. vegetarian" label, with unhealthy plant-based diets linked to increased diabetes risk [8][9]. Group 4: Recommendations for Healthy Eating - A balanced diet should include a mix of whole grains, vegetables, and quality protein sources, with a recommended meal composition of 1/4 carbohydrates, 1/2 vegetables, and 1/4 protein [12][13]. - Eating order matters; starting with vegetables, followed by protein, and then carbohydrates can help stabilize post-meal blood sugar levels [12][13]. - Cooking methods should favor steaming, boiling, or quick stir-frying over frying or heavy sauces, and using natural spices can enhance flavor without adding excess salt or sugar [12][13].

Core Insights - Many people consider consuming coarse grains as a healthy choice for controlling blood sugar, especially for those with high blood sugar or diabetes, but some coarse grains can actually cause blood sugar levels to rise more quickly than white rice or steamed buns [1] Group 1: High Glycemic Index Coarse Grains - Glutinous corn has a glycemic index (GI) of approximately 70-80, which is classified as high, leading to a faster increase in blood sugar levels compared to other grains [2] - Yellow millet porridge, particularly made from glutinous varieties, can raise blood sugar levels faster than white rice porridge, making it important for those with blood sugar issues to limit its consumption [2] - Baked sweet potatoes have a GI of 94, significantly higher than steamed ones (GI of 77), due to the conversion of some sucrose into faster-acting maltose during baking [2] Group 2: Factors Contributing to High Glycemic Response - The breeding of sweeter varieties of foods like sweet potatoes and pumpkins has resulted in higher sugar content and GI values compared to older varieties [3] - Overcooking grains increases the gelatinization of starch, leading to faster absorption in the intestines and a quicker rise in blood sugar [3] - Excessive processing, such as making mashed potatoes or grain pastes, removes dietary fiber that helps slow down sugar absorption, resulting in a doubled glycemic response [3] Group 3: Recommended Coarse Grains for Stable Blood Sugar - Whole grain cereals like oats, barley, and buckwheat have lower GI values compared to refined grains, aiding in better blood sugar control for diabetic patients [5] - Legumes such as red beans, green beans, and chickpeas have a milder GI, providing essential nutrients while avoiding excessive saturated fats and cholesterol [6] - Bran products, including oat bran and whole grain bread, are rich in dietary fiber, which helps slow digestion and sugar absorption, making them beneficial for diabetes management [7] - Germ foods like wheat germ and corn germ are nutrient-dense, containing vitamins, minerals, and healthy fats that support overall health, particularly for diabetic patients [7]

Core Viewpoint - The article discusses the potential effects of GLP-1 receptor agonists, commonly used for weight loss, on alcohol consumption and its effects, suggesting that these medications may reduce the sensation of intoxication and drinking desire [5][10]. Summary by Sections What are GLP-1 Drugs? - GLP-1 drugs, such as semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro), mimic natural hormones that regulate blood sugar and appetite [7]. Research Findings - A study involving 20 obese adults found that those taking GLP-1 drugs experienced a slower onset of intoxication and reduced feelings of drunkenness compared to those not on the medication. This effect is attributed to delayed gastric emptying, which slows the absorption of alcohol into the bloodstream [8]. - Participants on GLP-1 drugs reported lower drinking desires, and the study indicated that the reduced intoxication was not due to nausea or blood sugar changes, suggesting a unique mechanism of action through the gut [8]. Limitations and Future Research Directions - The study is a small preliminary trial without random assignment, focusing solely on obese patients. More extensive research is needed to determine the effectiveness, long-term effects, and optimal dosages for blood sugar control and alcohol reduction [9]. - Experts caution that the findings do not establish causation and highlight the need for future studies to track overall alcohol intake and drinking desires to assess potential compensatory behaviors [9]. Potential for Addiction Treatment - Emerging data suggest that GLP-1 drugs may play a role in addiction treatment, as GLP-1 receptors influence reward signals related to food, alcohol, and nicotine. If validated in larger studies, these drugs could bridge endocrinology and behavioral health [10].

Core Insights - The global prevalence of Type 2 Diabetes (T2D) is rising, with 529 million cases reported in 2021, projected to exceed 1.3 billion by 2050, highlighting an increasing public health burden [2] - Current drug therapies, including GLP-1 receptor agonists, have been developed to manage high blood sugar, but a significant portion of patients still experience poor glycemic control due to clinical inertia and patient non-adherence [2] - There is an urgent need for alternative methods that can provide sustained blood sugar control independent of daily patient adherence [2] Group 1 - A multicenter, open-label, single-arm study published in the journal Signal Transduction and Targeted Therapy evaluated catheter-based endovascular denervation for T2D patients with poor glycemic control [3] - The study involved 37 patients, with 30 undergoing endovascular denervation (EDN) treatment between December 2022 and October 2023, assessing safety and efficacy [4] - The primary endpoints included the incidence of major adverse events (MAE) within 30 days post-surgery and changes in HbA1c levels at 6 months [4] Group 2 - Patients had a baseline average HbA1c of 9.0% and fasting blood glucose of 8.6 mmol/L; no MAE were observed within 30 days post-treatment [5] - At 6 months, HbA1c levels decreased by 1.0%, with significant improvements in blood glucose control observed at 1, 3, 6, and 12 months [5] - 37% of patients reported mild to moderate gastrointestinal adverse events, indicating the need for further randomized controlled trials to validate the efficacy of EDN in improving glycemic control in T2D patients [5]

Core Insights - Diabetic retinopathy ('sugar net') often shows no early symptoms, leading many patients to seek medical help only after experiencing significant vision issues, indicating irreversible retinal damage [1] - Approximately one-third of diabetic patients will develop diabetic retinopathy, with other eye complications including cataracts and neovascular glaucoma [1] - Long-term high blood sugar levels increase the permeability of retinal blood vessels, causing leakage and retinal edema, which can ultimately lead to vision loss [1] Group 1 - Diabetic retinopathy is not exclusive to the elderly; younger individuals are increasingly affected, with rapid disease progression noted in younger patients due to faster metabolism and proliferation [2] - Regular eye examinations are crucial for early detection and management of diabetic retinopathy, especially for younger patients [2] - Strict blood sugar control is essential to reduce vascular damage and improve retinal oxygenation, thereby lowering the risk of disease progression [2]

Core Viewpoint - The belief that a vegetarian diet alone can effectively control blood sugar levels is misleading, as blood sugar management depends on a balanced overall diet rather than simply avoiding animal products [2][4][23]. Dietary Structure - Effective blood sugar control is influenced by the overall dietary structure, including the types of carbohydrates consumed and their glycemic index (GI) and glycemic load (GL) [5][7]. - High-GI foods (GI > 70) can cause rapid increases in blood sugar, while low-GI foods (GI ≤ 55) help maintain stable blood sugar levels [5][6]. Misleading Vegetarian Choices - Certain starchy vegetables (e.g., potatoes, yams) and heavily processed vegetarian dishes (high in sugar and oil) can lead to significant blood sugar spikes if consumed in excess [9][11]. - A diet high in unhealthy vegetarian options can increase the risk of diabetes, contrary to the belief that vegetarianism is inherently healthy [12][13]. Nutritional Quality - The quality of food is more important than the "meat vs. vegetarian" label; unhealthy vegetarian diets can lead to nutrient deficiencies and health risks [12][15]. - Key nutrients such as protein, vitamin B12, iron, zinc, and omega-3 fatty acids may be lacking in poorly planned vegetarian diets, affecting overall health and blood sugar stability [15]. Healthy Eating Strategies - A balanced approach to eating, including a mix of whole grains, vegetables, and quality proteins, is essential for effective blood sugar management [17][18]. - Recommended eating patterns include prioritizing vegetables and proteins before carbohydrates, using healthy cooking methods, and incorporating natural spices for flavor [19][20][22]. Conclusion - Instead of focusing solely on whether to eat meat or not, individuals should concentrate on achieving a balanced diet, making informed food choices, and employing healthy cooking techniques to maintain stable blood sugar levels [24][25].

Core Viewpoint - The article highlights the increasing prevalence of diabetes in China, emphasizing the health risks associated with high blood sugar levels and the importance of monitoring and controlling blood sugar to prevent complications. Group 1: Diabetes Prevalence and Risks - Diabetes has become the third most significant chronic non-communicable disease affecting public health in China, with the prevalence continuously rising [1] - High blood sugar levels can lead to various health issues, often without noticeable symptoms, causing ongoing damage to the body [1] Group 2: Symptoms Indicating High Blood Sugar - Changes in the legs and feet can signal uncontrolled blood sugar levels, as small blood vessels are often damaged first, leading to noticeable symptoms in these areas [3] - Common symptoms of high blood sugar include slow wound healing, itching, numbness in legs and feet, appearance of "sugar spots," and dry skin [6][7][8][9][10][11] Group 3: Blood Sugar Control Strategies - Effective blood sugar management involves not only lowering blood sugar levels but also maintaining stability to prevent complications such as heart attacks and kidney damage [13] - Recommended strategies for controlling blood sugar include increasing whole grains in the diet, eating harder foods, slowing down eating speed, adjusting the order of food intake, and being mindful of the glycemic index (GI) and glycemic load (GL) of fruits [15][16][17][18][19][20][21] - Regular exercise is also emphasized as a crucial component for lowering blood sugar and improving insulin response [22]

Core Viewpoint - The article discusses the significant weight loss effects of oral semaglutide in overweight or obese patients without diabetes, highlighting the results of the OASIS 1 study and the PIONEER PLUS study, which demonstrate its efficacy and safety in weight management and blood sugar control [6][20]. Group 1: OASIS 1 Study Findings - The OASIS 1 study showed that daily oral administration of 50mg semaglutide led to an average weight loss of 15.1% after 68 weeks, with 85% of participants achieving clinically meaningful weight loss (≥5%) [6][9]. - The study included 667 adults with a BMI of ≥30kg/m² or ≥27kg/m² with weight-related complications, randomly assigned to either the semaglutide group or a placebo group [6][8]. - The treatment demonstrated a significant difference in weight loss compared to the placebo group, which only saw a 2.4% reduction (p<0.0001) [9][11]. Group 2: PIONEER PLUS Study Insights - The PIONEER PLUS study focused on the effects of high-dose oral semaglutide on blood sugar control in patients with type 2 diabetes and obesity, showing that higher doses (25mg or 50mg) resulted in better glycemic control and weight loss compared to the standard 14mg dose [20]. - Results indicated that the 50mg dose group achieved an average HbA1c reduction of 2.0%, with 63% of patients reaching the target HbA1c <7.0% [18][20]. - The study also reported that patients in the higher dose groups had a higher percentage of weight loss exceeding 5% or 10% compared to the standard dose group [18][20]. Group 3: Safety and Tolerability - The overall tolerability of semaglutide treatment was good, with 80% of patients reporting gastrointestinal adverse effects, mostly mild to moderate [13][15]. - The incidence of any adverse events was higher in the semaglutide group (91.9%) compared to the placebo group (85.6%), but serious adverse events were relatively low [15]. - Common adverse events included nausea (51.8% in the semaglutide group) and gastrointestinal disorders, but no fatal events were reported [15].